Question 1

Before the simulation procedure,the therapist should explain the procedure appropriate to the patient's level of understanding and inform the patient of what will be required of him or her during the procedure.

Accepted Answer

The radiation therapist should establish an environment conducive to communication.If there are distractions in the area,such as unwanted noises or the usual distractions of a radiation oncology department,it may be preferable to retreat to a private area to communicate with the patient (the simulator room is much better for this than a busy waiting room).Prior to the simulation procedure,the therapist should explain the procedure appropriate to the patient's level of understanding and inform the patient what will be required of him/her during the procedure.

Question 2

The PTV planning volume will contain margins for geometric uncertainties,such as:

Accepted Answer

PTV indicates the CTV plus margins for geometric uncertainties,such as patient motion,beam penumbra,and treatment setup differences.

Question 3

Most treatment planning on the fluoroscopy-based simulator is divided into two types of procedures: SAD and SSD setups.

Accepted Answer

Most treatment planning on the fluoroscopy-based simulator is divided into two types of procedures: SAD and SSD setups.Both methods may use fluoroscopy to initially view the area.The decision to use one setup method over the other may be decided by many factors.They include the nature and extent of the patient's disease and the goals and expected outcome of the treatment (cure or palliation).

Question 4

_______________________ contours are the most accurate of all transverse contouring methods.

Accepted Answer

CT-generated contours are the most accurate of all transverse contouring methods,because there is no hand molding or manipulation to introduce significant error.

Question 5

According to ICRU Report 62,another term used to describe critical structures that may limit the amount of radiation delivered to the tumor volume is _________________.

Accepted Answer

ICRU Report 62 updates ICRU Report 50 regarding a further defining of organs at risk (OAR),which are critical structures that may limit the amount of radiation delivered to the tumor volume.

Question 6

A patient's separation (IFD)= 14.5 cm.If the posterior SSD = 94 cm,what will the anterior SSD measurement be?

Accepted Answer

Separation refers to the measurement of the thickness of a patient along the CA or at any other specified point within the irradiated volume.Separations are helpful in calculating the amount of tissue in front of,behind,or around a tumor.

Question 7

A patient's separation (IFD)= 24 cm.If the posterior SSD = 89 cm,what will the anterior SSD measurement be?

Accepted Answer

Separation refers to the measurement of the thickness of a patient along the CA or at any other specified point within the irradiated volume.Separations are helpful in calculating the amount of tissue in front of,behind,or around a tumor.

Question 8

Orthogonal images are two images taken at right angles to one another and are usually included as part of the fluoroscopy-based simulation procedure.

Accepted Answer

Orthogonal films are two radiographs taken at right angles to one another.They are often obtained to aid in the treatment planning process.Usually an AP (anteroposterior)and lateral projections are used to obtain information on the treatment depth and to establish an anterior setup distance as a reference point during fluoroscopy-based simulation.

Question 9

Complex immobilization devices are time consuming to construct,but relatively inexpensive to make.

Accepted Answer

Although complex immobilization devices are somewhat time consuming and costly to make,they allow for customized patient positioning options.They typically provide more stability and prevent patient movement and are usually time saving in daily treatment procedures,thus justifying the cost for many practitioners.

Question 10

Presimulation planning includes the localization of disease using radiography and fluoroscopy.

Accepted Answer

Ideal presimulation planning includes an assessment of all relevant patient information and an evaluation of possible treatment approaches before the patient arrives.This is especially true for difficult cases,involving patients who have had previous treatment or have extensive disease.

Quiz 22: Conventional Fluoroscopy-Basedsimulation Procedures